There is a major gap between public health messages, women’s intentions and actual practices when it comes to breastfeeding.
I’ve experienced this first hand as a new mother. The major topic of conversation amongst new mothers tends to center around breastfeeding and ensuring that our babies’ needs are being met. Whether your baby is getting enough to eat, gaining weight and thriving are paramount concerns.
The public health message is breast is best, and that exclusive breastfeeding provides important health benefits to both babies and mothers, however there is tremendous variation within Ontario around access to breastfeeding support from qualified health care providers.
Some hospitals offer breastfeeding clinics, and have providers with training in lactation while others do not; some public health units have nurses visit new mothers within the first week of a child’s birth to offer breastfeeding support while others do not. Some primary care providers, like Community Health Centres or family practices have staff trained in lactation, but many do not. A quick Google search reveals that there are many private lactation consultants, with varying levels of training who offer home visits for breastfeeding issues, however their services come at a steep out of pocket cost to new parents.
This lack of standardization for breastfeeding support across the province sets up many new mothers to fail when they encounter breastfeeding challenges.
The World Health Organization and Health Canada recommend that women exclusively breastfeed babies from birth until six months of age. While over 90% of women in Canada intend to breastfeed their babies, and about 90% of women initiate breastfeeding – just over 50% are breastfeeding when their babies are six months old.
A breastfeeding problem – such babies having trouble latching, or questions about milk supply – often emerge once women have been discharged home and when their milk comes in a few days after the baby is born. Being able to coordinate the schedule of a new baby to the hours of a hospital or public health breastfeeding clinic can be difficult. In this context of a fractured system, and challenges accessing services, it is no surprise that within the first week of birth, one in five women supplement breastfeeding with formula, and one in four by the second week.
Considering the benefits of breastfeeding for infant and child health, as well as maternal health, there ought to be more readily accessible support and increased standardization to ensure breastfeeding support from the heath care system.
One approach that has demonstrated significant breastfeeding success is the midwifery model – in Ontario, midwifery clients receive six weeks of postpartum care from their midwifery team. Midwives are trained in breastfeeding support, and over 90% of midwifery clients in Ontario are exclusively breastfeeding their babies at 6 weeks post partum. Part of this model of care includes home visits to the new mother and baby within the first week of hospital discharge, and frequent clinic visits for the first six weeks after birth. Rather than having a new mother experiencing breastfeeding difficulty seeking out care, she is assured by having regular access to a provider trained in lactation support.
Leveraging from this model could help support breastfeeding success. It should be the standard of care across the province, regardless of region or birth provider, that a new mother is offered a scheduled visit with a publicly funded health care professional trained in lactation within the first week of their child’s life, along with any necessary follow-up appointment within the first six months of life.
Breastfeeding is too important for both babies and mothers to have it fall between the cracks of the health care system.